The Correlation of the Neutrophil-Lymphocyte Ratio and the Platelet-Lymphocyte Ratio With Pathological Findings in Neuroendocrine Tumors

Abstract

Introduction The relationship between clinical prognostic factors and blood neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in some tumors has been investigated. In this study, we examined whether there is a relationship between pathological prognostic factors and NLR as well as PLR only in neuroendocrine tumors (NETs). Methods A total of 115 patients with a NET diagnosis between 2014-2020 were included in the study. The efficiency of NLR and PLR in predicting distant metastases was determined by analyzing the receiver operating characteristic (ROC) curve. The relationship between histopathological parameters was also compared. Results The cut-off value of NLR was 3.01 for predicting distant metastasis. At this value, the specificity was 73.7%, the sensitivity was 70.7%, and the likelihood ratio was 2.51. There was a significant relationship between NLR and tumor localization, histological grade, mitosis, Ki-67, distant metastasis, and lymphovascular invasion (all p<0.001). The cut-off value of the PLR in predicting distant metastasis was 134.4. At this value, the specificity was 59.6%, the sensitivity was 58.6%, and the likelihood ratio was 1.44. There was no significant relationship between PLR and the histopathological findings (all p>0.05). Conclusions In our study, a high histological grade, high mitosis, a high Ki-67 proliferation index, distant metastasis, and lymphovascular invasion were found in patients with NLR at a cut-off value above 3.01. However, we could not attain the same results for PLR. For trucut and endoscopic biopsies in particular, follow-up of patients with grades 1 and 2 NETs along with histopathological findings and evaluation of NLR in peripheral blood may be useful. NLR, which is an easily accessible inflammatory marker, can be used as an independent predictive factor in NETs.

Inflammation Related to Obesity in the Etiopathogenesis of Gastroenteropancreatic Neuroendocrine Neoplasms

“…In recent years, indicators, such as neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR), calculated on the basis of inflammatory markers circulating in the blood, have aroused interest [ 134 ]. An association between high NLR and tumor size, stage, high grade, shorter survival in NEN patients has been observed.…”

“…However, some studies do not support the importance of PLR as a predictor of the presence of metastases or multifocal disease [ 137 ]. Kulahci et al [ 134 ], based on retrospective studies performed in 2014–2020 on patients with NETs, found a correlation between a higher NLR value (cut-off value above 3.01) and tumor location, higher histological grade, increased mitosis, higher Ki-67 proliferation index, metastases, and lymphatic involvement. In the case of PLR, no such correlations have been observed.…”

Neutrophil-to-Lymphocyte Ratio as a Marker for Cardiac Autonomic Neuropathy in Egyptian Patients With Type 2 Diabetes: A Cross-Sectional Study

“…These factors are very costly to be used as a screening tool. Thus, there is a need to find a reliable marker for the early detection of diabetic complications [3].…”